New Client Intake Forms
The following documents must be completed prior to confirmation of your child’s initial appointment:
Intake Form
Policies and Procedures Acknowledgement
Media Release
INTAKE FORM:
POLICIES AND PROCEDURES:
Welcome and thank you for choosing Brave Babies LLC for your physical therapy, developmental support, and wellness needs. Please carefully review and acknowledge the sections below.
Purpose and Explanation of Service
Brave Babies LLC provides baby developmental support sessions, motor skill screening, caregiver coaching, and educational services. These services are intended to support age-appropriate development, answer caregiver questions, and offer movement-based guidance for families. They are not a substitute for emergency care.
Transition to Physical Therapy
If, during the course of services, it becomes clear that my child would benefit from a formal physical therapy evaluation or treatment, I understand that Brave Babies LLC may recommend transitioning to the pediatric physical therapy service track, if appropriate.
Scope of Service
These sessions may include developmental observation, positioning guidance, play-based coaching, caregiver education, and home activity suggestions. I understand that the level of service provided will depend on my child’s needs and that some children may later require a more medically directed plan of care.
Informed Consent
I understand that my child’s participation may involve observation of movement, guided play, caregiver demonstration, and age-appropriate handling. I understand that responses to services vary and that some activities may cause temporary fussiness or mild discomfort. I agree to communicate any concerns during the session.
Cooperation with Services
I understand that caregiver participation is important for these sessions. I agree to practice suggested activities when appropriate and to communicate questions or concerns with my provider.
Hybrid Model and Mode of Operations
Brave Babies LLC offers services in a hybrid model. Depending on the service type, appointments may occur in-home, in the community, or at the provider’s location in Plantation, FL. For home visits, appointment times include a buffer of up to 15 minutes to allow for traffic, parking, setup, and transitions between visits. This buffer is built into scheduling and does not automatically extend the session length unless approved by the provider.
Confidentiality and Privacy
Information obtained during services will be treated as confidential and will not be shared without written consent, except as otherwise required by law. I understand that if I request sharing of records with another party, a separate authorization may be required.
Payment Agreement
Brave Babies LLC is a fee-for-service practice. Payment is due at the time of service unless otherwise agreed upon in writing. I understand that fees for these services may not be reimbursed by insurance and that I am financially responsible for all charges incurred.
Cancellation Policy
I acknowledge that if I must cancel a session, I will provide at least 24 hours’ notice. If I cancel within 24 hours of the scheduled session start time, I may be charged for that session. All sales for consultations, developmental support sessions, coaching, or educational services are final and nonrefundable unless otherwise stated in writing.
Acknowledgement
I acknowledge that I have read this document in its entirety or that it has been read to me if I was unable to read it. I consent to the rendition of all services as explained herein by Brave Babies LLC personnel
MEDIA RELEASE (OPTIONAL):
For all media produced identifying information, including name and specific location, will be kept confidential and will not be disclosed in connection with any photographs or video.